Medicare State by State Coverage

Navigating the confusing waters Medicare and Medicaid plans, often leaves its participants confused. Medicare and Medicaid plans cover the medical needs of the participants. Many view these plans as one in the same. Understanding a few details of Medicare and Medicaid programs helps to protect assets and better prepare for the future.

What is Medicare?

Medicare is a Federal program that assists with payments of the high cost of medical care for citizens age 65 and over. The program is a benefit for those who have paid through social security taxes. The Medicare program is not a need-based program. Medicare plans rules are the same throughout the country because it is a federal plan. Payment confusion with Medicare plans often arise when participants are enrolled in both Medicare and Medicaid programs.

What Type of Program is Medicaid?

Medicaid is a state program whose eligibility is determined by need. Medicaid provides comprehensive patient health coverage for all ages. Medicaid coverage and eligibility vary from state to state. Not all Medicare participants are automatically eligible for Medicaid. Those who use both programs have basic coverage for health care and prescriptions. Some state Medicaid plans will pay for Medicare premiums and deductibles. Because this is a state program, it is best to contact your state agency for coverage details.

Coverage for Non-Eligible Medicaid Participants

Two-thirds of the Medicare population is not eligible for the Medicaid program. Those who want more coverage for their Medicare plans will often buy supplemental or “Medi-gap” insurance. This private insurance offers extra coverage for uncovered parts of the participant’s Medicare plan. Beware of the premiums and cost of this policy over time. As your income continues to decrease, some plans become very expensive to maintain. Read all the fine print and ask plenty of questions before paying for these insurance plans. Understanding your Medicare plan and eligibility for other insurance programs will save time and money.